Patient's Death Lands Clinician in Court for Advising Cessation of Aspirin Therapy

Dr. L could have protected herself by referring the patient to a cardiologist for follow up

Dr. L felt rushed. The 49-year old general practitioner always seemed to feel rushed these days. The primary care practice where she was employed had several physicians and nurse practitioners, but it never felt like enough. Dr. L often wished that she had a chance to more carefully review a patient's records, or spend more time speaking with a particular patient, but the crowded waiting room prevented it.

On this specific day, she wished that she had a little more time to look over her patient's chart before talking to him in the exam room. This particular patient, Mr. F, 59, had been in the hospital six days ago and this was his first appointment since being released. Dr. L tried to take a minute to review his records while her medical assistant was taking the patient's vitals, but there was a lot to look through.

“I heard you were in the emergency department last week,” she said to Mr. F, as she skimmed the records sent from the hospital. “What happened?”

“My chest started hurting real bad one evening,” Mr. F told his doctor. “It went on for a half hour but it felt like hours to me. My wife was so scared. She insisted on calling 911. I didn't want to… I probably would have just tried to wait, but she insisted.”

“That's understandable,” said the physician.

“In the ambulance, the emergency medical techs gave me aspirin and something else, and like a miracle, the chest pain got a lot better,” said the patient.

“The other thing was nitroglycerin,” said the physician, glancing at the notes.

“Then they ran a bunch of tests and said I wasn't having a heart attack,” said the patient.

The physician looked at the patient's record and saw the results from an EKG and serial cardiac enzyme tests – all normal.

“Then I had to sit around in the hospital while they decided what to do with me, and finally they gave me a stress test and said I was ‘normal.' They kept me overnight for observation and then they sent me home and told me to see you. And here I am,” said the patient.